Abstract
This case report describes a rare manifestation of acute compartment syndrome (ACS) involving all four extremities, precipitated by angio-oedema in a middle-aged woman who consumed an overdose of multiple medications: nifedipine, azelnidipine, amlodipine besylate, olmesartan medoxomil, telmisartan, esaxerenone and vildagliptin. She presented with haemodynamic instability, necessitating intubation. Despite stabilising haemodynamic parameters within 24 hours, she manifested escalating extremity oedema. At 52 hours after ingestion, mottled skin was observed, along with necrotic alterations in the swollen hands and compartment pressures exceeding 30 mm Hg in all extremities. ACS was diagnosed, leading to fasciotomies. The aetiology is postulated to be drug-induced angio-oedema, possibly intensified by the concurrent overdose of olmesartan medoxomil, telmisartan and vildagliptin, each of which has a risk of angio-oedema even at standard dosages. This scenario is a very rare case caused by drug-induced angio-oedema, which underscores the importance of vigilant monitoring to detect ACS in patients with progressing limb oedema.
Reference22 articles.
1. Angioedema and emergency medicine: from pathophysiology to diagnosis and treatment;Depetri;Eur J Intern Med,2019
2. Consensus statement on the diagnosis, management, and treatment of angioedema mediated by bradykinin. part II. treatment, follow-up, and special situations;Caballero;J Investig Allergol Clin Immunol,2011
3. The EAACI/Ga2Len/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria;Zuberbier;Allergy,2018
4. Acute angioedema
5. Telmisartan, Ramipril, or Both in Patients at High Risk for Vascular Events
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献